The aim of study was to compare and analyze surgical success and patient satisfaction in doing external dacryocystorhinostomy and endonasal endoscopic dacryocystorhinostomy for the management of primary acquired nasolacrimal duct obstruction at tertiary care referral hospital in kathmandu, nepal. Outcome and impact on the quality of life of the patients islamr. Endoscopic endonasal dacryocystorhinostomy dcr is the best, scar free no scar, lacrimal surgery performed for restoration of tears flow into the nose from the lacrimal sac, when the nasolacrimal duct tear duct has become blocked blocked tear duct tear duct obstruction abnormal tearing or epiphora watery eyes takes place due to obstruction in the drainage system of. We present a retrospective case series of 498 endoscopic dacryocystorhinostomies on 401 patients, from july 2004 to may 2018, at the department of otolaryngology, san raffaele hospital, milan, italy. Endoscopic view of the raising of the mucosal flap. Caldwell first described the endonasal approach in 1893 18. Conventional dacryocystorhinostomy versus endonasal dacryocystorhinostomya comparative study saroj gupta, rashmi goyal, a. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Conventional dacryocystorhinostomy versus endonasal. Camara jg, bengzon au, henson rd 2000 the safety and efficacy of mitomycin c in endonasal endoscopic laserassisted dacryocystorhinostomy.
Results of endonasal laserassisted dacryocystorhinostomy. No impact of nasal septoplasty on the outcome of endoscopic. Powered endoscopic dacryocystorhinostomy with mucosal. Bilateral simultaneous endoscopic dacryocystorhinostomy endodcr has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Dacryocystorhinostomy dcr this leaflet explains about dacryocystorhinostomy dcr including the benefits, risks. A prospective series of 104 consecutive endonasal dcrs. With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. An incision has been made on each side of the nose with a 15 blade. Dacryocystorhinostomy dcr in children is indicated in cases of common congenital nasolacrimal duct obstruction cnldo unresponsive to medical therapy, probing or intubation. In total, 442 patients underwent an endoscopic dacryocystorhinostomy. Endoscopic dcr is a minimally invasive procedure to unblock tear ducts. Since then, endonasal endoscopic dcr ees dcr was performed more frequently in pando and successful results were reported. In most series reported, it appears that enddcr had a higher failure rate than extdcr. The success rate was 91% 5156, and the mean operation time was 44 minutes.
Endoscopic ultrasonic dacryocystorhinostomy for recurrent. The study was approved by ethics committee for research on human beings. The child is positioned in standard sinus surgical fashion and draped such that both the nose and affected eye are included in the operative field. Stevens scissors are used to bluntly dissect to the. The study involved a prospective nonrandomised interventional case series with short perioperative follow up. Saratziotis a, emanuelli e, gouveris h, babighian g. Endoscopic dacryocystorhinostomy edcr using telescopes has gained. Uncontrolled epithelialization of the surgical site as compared with the fashioning of mucosal flaps may explain the somewhat lower success rate. The operation is very similar to external dcr, except there is no cut through the skin and no scar afterwards. Because of difficulty in visualizing the nasal cavity, the endonasal approach fell out of favor, and for the next 100 years, a slightly modified external approach remained the treatment of choice for primary acquired nasolacrimal duct obstructions pando. Basic technique and keys to success learning objective upon completion, participants should be able to. Objectives to describe powered endoscopic dacryocystorhinostomy dcr with full sac exposure and primary mucosal anastomosis and report perioperative and followup results achieved with this.
Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction. Pdf the impact of endonasal dacryocystorhinostomy dcr. Endonasal endoscopic dacryocystorhinostomy in children. Techniques in endonasal dacryocystorhinostomy springerlink. Endonasal endoscopic dacryocystorhinostomy in misrata. Stents bilateral dacryocystorhinostomy dcr eye care. Pediatric endonasal endoscopic dacryocystorhinostomy. External dacryocystorhinostomy versus endoscopic endonasal. This is a new technique that involves creation of a large rhinostomy and mucosal flaps. Coding endoscopic sinus surgery ahima 2008 audio seminar series 11 notescommentsquestions diagnostic evaluation all diagnostic evaluations include all of these areas do not code each area separately. Excessive unilateral or bilateral tearing interfering with vision and persistent neglect of the symptom may induce chronic dacryocystitis, resulting in purulent. Endoscopic dacryocystorhinostomy edcr is a currently wellestablished surgical treatment for.
Endoscopic dacryocystorhinostomy the lead on this matter and although data in the paediatric group are not so common as in adults, endoscopic endonasal dcr is being increasingly used and offers advantages, especially in children, over external dcr with the same success rates reported in the literature. Health, general dacryocystorhinostomy usage nasolacrimal ducts care and treatment research signs and symptoms analysis symptomatology. Twelve patients with dacryocystitis and canalicular obstruction underwent a conventional endoscopic endonasal. Describe the basic steps of endoscopic dacryocystorhinostomy. Dacryocystorhinostomy dcr is currently regarded as the treatment of choice for treatment of epiphora resulting from blockage at the level of the nasolacrimal duct.
Pdf obstruction of the lacrimal pathway is manifested by epiphora, infection, and. There has been debate on the effect of healing on the size of the dcr ostium after surgery. Original article problems complications, success rate. The objective of present study was to compare the results of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Endoscopic view showing incision to create a posteriorly based mucosal flap to expose the lacrimal bone and frontal process of the maxilla. The endoscopic approach has several advantages, including the following. Only minor and transient complications were observed in 2 of the patients. Bilateral endoscopic dacryocystorhinostomy was performed in 12 patients. In the last 15 years, endonasal dacryocystorhinostomy enddcr has become an alternative to external dacryocystorhinostomy. Mechanical endonasal dacryocystorhinostomy with mucosal. The dacryocystorhinostomy operation, which involves fistulization of the lacrimal sac into the nasal cavity, may alleviate the symptoms. This video demonstrates the performance of a bilateral dacryocystorhinostomy. The adult dacryocystorhinostomy n 577 had an anatomical success of 90. A retrospective noncomparative case series of dacryocystitis with canalicular obstruction has been studied.
Twentyeight patients 16 female, 12 male were enrolled in this study, with a mean age of 55 years old range. Nonendoscopic endonasal dacryocystorhinostomy springerlink. The aim of study was to compare and analyze surgical success and patient satisfaction in doing external dacryocystorhinostomy and endonasal endoscopic dacryocystorhinostomy for the management of primary acquired nasolacrimal duct obstruction at tertiary care referral hospital in. Mohamed4, khalid alqahtani5, talal alkhatib6 and abdullah alghamdi7 abstract. The original intranasal approach was described in 1893 by caldwell 1 and the external approach in 1904 by toti. Bilateral simultaneous endoscopic dacryocystorhinostomy ncbi. Hi there, my mom just had a bilateral dcr done with stents inserted a couple days ago. Dacryocystorhinostomy endoscopic endonasal is a good alternative on the treatment of nasolacrimal duct obstruction. Bilateral simultaneous endoscopic dacryocystorhinostomy. To determine the outcome of dacryocystorhinostomy dcr for nasolacrimal duct obstruction nldo in children.
Original article by journal of evolution of medical and dental sciences. Seventyseven patients underwent endoscopic dacryocystorhinostomy endcr and 58 underwent external dacryocystorhinostomy exdcr in a standardized fashion by the same surgical team between 2007. Caldwell 1 and toti 2, respectively, described the endonasal and external approaches to dacryocystorhinostomy dcr 1, 2. The aim of this study is to propose a simple and efficient combination surgery for the management of dacryocystitis with canalicular obstruction. Lacrimal drainage obstruction and dacryocystorhinostomy in.
Increased concomitant nasal procedure frequency in bilateral endoscopic dacryocystorhinostomy. She can see the stents at the inner corner of her eyes and feels that theyre rubbing against her eyes every time she moves her eyeballs. The medial wall of the sac is incised or excised, facilitating drainage of tears into the nasal cavity. The leading causes of the unsuccessful outcomes of endoscopic endonasal dacryocystorhinostomy are deviation of nasal septum, concha bullosa and. Of the 342 patients, 243 underwent unilateral surgery and 99 underwent bilateral surgery. Pdf endoscopic dacryocystorhinostomy as treatment for lower. Read simultaneous bilateral endonasal endoscopic dacryocystorhinostomy. Endoscopic dacryocystorhinostomy, epiphora, lacrimal stents introduction caldwell1 was the first to describe an endonasal approach to. Overall, the authors believe that a bilateral endoscopic dacryocystorhinostomy would be useful in.
Silicone stents were used in 93% of interventions with a mean time to. The latter approach may use rigid telescopes or the microscope. Endoscopic dacryocystorhinostomy oculoplastic eyelid. Endonasal dacryocystorhinostomy is performed in many places as an endoscopic operation with the aid of rigid optics. Of the 12 patients studied, four underwent bilateral surgery, totalling 16 procedures. The first clinical study of endoscopic dcr was published in 1989. Rhinological aspects of endonasal endoscopic dacryocystorhinostomy abstract the endoscopic endonasal dacryocystorhinostomy is a modern and effective surgical treatment of lacrimal pathways obstruction. The group can be split in unilateral or bilateral surgery. Analysis of 34 cases of endonasal endoscopic dacryocystorhinostomysurgical success and patient satisfaction, a case series, our experience. Seventyseven patients underwent endoscopic dacryocystorhinostomy endcr and 58 underwent external dacryocystorhinostomy exdcr in a standardized fashion. Surgical outcomes of endoscopic dacryocystorhinostomy. Endoscopic endonasal dacryocystorhinostomy combined with. A modified preserved nasal and lacrimal mucosal flap technique in endoscopic dacryocystorhinostomy.
Original research article open access endoscopic dacryocystorhinostomy dcr. The purpose of this manuscript is to evaluate the effectiveness of endonasal endoscopic pediatric dcr. Problems complications, success rate endoscopic dacryocystorhinostomy 19 vol. Include duct probe in dacryocystorhinostomy supercoder. The operative approach to the sac may be external or endoscopic. Dacryocystorhinostomy dcr is an operation that has been used for the past 100 years. Comparison of external and endonasal dacryocystorhinostomy. To describe and assess the efficacy of mechanical endonasal dacryocystorhinostomy mendcr. All of these patients were older than 12 years old.
Hospital based prospective, comparative, nonrandomized, interventional. Six patients required septoplasty during the dcr procedure. The use of general anesthesia is typically necessary in children. Pediatric endonasal endoscopic dacryocystorhinostomy is a safe and effective procedure to correct nasolacrimal system obstruction in cases that are unresponsive to conservative treatments. Endoscopic assessment of the dacryocystorhinostomy ostium. You can no longer report 68810 or 68811 along with those three codes unless it is a separate procedure, marked with modifier 59 distinct procedural service. Wegeners granulomatosis wg is one form of idiopathic autoimmune vasculitis. Ten patients underwent a bilateral procedure, 6 of them, at the same time. A modified preserved nasal and lacrimal flap technique in. Fiftynine patients underwent unilateral endoscopic dacryocystorhinostomy. Endoscopic dacryocystorhinostomy dcr iowa head and.
The aim of this study is to determine how the size of the surgically created lacrimal ostium changes over time. Simultaneous bilateral surgery was performed in 530. Endoscopic dacryocystorhinostomy in functional lacrimal obstruction. Endoscopic septoplasty was needed in 21 patients who had a high septal deviation. Successful endonasal dacryocystorhinostomy in a patient. A low cost, fast, and successful method, journal of craniofacial surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Introduction bilateral simultaneous endoscopic dacryocystorhinostomy endodcr has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct. Mechanical endonasal dacryocystorhinostomy with mucosal flaps. External dacryocystorhinostomy versus endoscopic endonasal dacryocystorhinostomy. Endonasal endoscopic dacryocystorhinostomy requires a joint otolaryngologicophthalmologic team approach. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. Excessive unilateral or bilateral tearing interfering with vision and.